Deciding where to have your baby and the type of care you want during your pregnancy (antenatal care), the birth and after your baby is born (postnatal care) is a major decision. The following information is for people who live in South Australia.

Deciding where to have your baby and the type of care you want during your pregnancy (antenatal care), the birth and after your baby is born (postnatal care) is a major decision.

The following information is for people who live in South Australia.

There are many options available to you. This section gives some brief information on most of the choices available. Your doctor (general practitioner) or a midwife at a public hospital will be able to provide you with more information about your choices.

If you need your first antenatal appointment in a public metropolitan maternity service in Adelaide or Gawler you will need to call the Pregnancy SA Referral Line on 1300 368 820. You will be allocated to the hospital closest to your home.

In metropolitan Adelaide public antenatal care is available at Flinders Medical Centre, Lyell McEwin Hospital, the Women's and Children's Hospital, Modbury Hospital, and Noarlunga Health centre. Women can no longer have their babies at Modbury Hospital or The Queen Elizabeth Hospital. Women can also have their babies at the Gawler Hospital.

Some services offer appointments in the community closer to where women live - check with your midwife or doctor to see if these clinics are suitable for your needs.

Pregnancy and childbirth are natural life events, and in most cases women will have a natural, vaginal birth.

While all women hope for a normal pregnancy and birth, there is always a chance of problems happening in pregnancy and childbirth - for the mother, baby or for both of you.

Some problems are found early in pregnancy and other problems may develop later in a pregnancy or during labour or the birth.

The purpose of antenatal care is to identify problems and manage them in the best possible way for you and your baby.

Where possible you will be given choices about the type of care that you have. Being involved in making decisions can help make sure that you feel comfortable with everything that is done for you and your baby.

All women in South Australia can choose to be public patients, but not all types of care are available everywhere in South Australia. Some choices are not available outside of metropolitan Adelaide, although several country hospitals are able to care for mothers both as public and private patients.

All women can also choose to have their care provided by a private specialist doctor, and the birth at a private or public hospital.

All Australian residents can choose to be Public patients. If you are eligible for a Medicare card, most of your hospital care in a public hospital will be free of charge.

When admitted, your accommodation and treatment will be free.

When you are discharged there may be a co-payment for medicines if they are required.

When you attend a public hospital as a non-admitted patient (out-patient), there may be some charges, such as charges for some surgical supplies, or co-payments for medicines if they are required.

If you do not have a Medicare card, check with the Medicare Office on 13 20 11 about your eligibility.

If you decide to have your baby in a public hospital,

The birth will generally take place in the birthing centre suite or delivery suite (labour ward).

The hospital midwives and doctors will look after you during the birth. As a public patient you have limited opportunity to choose your own midwife or doctor.

After the birth, if everything has gone well and is normal you may return home anywhere from 6 hours to 3 days after the birth. Midwives will visit you at home after you have been discharged.

If you need to stay in hospital for any reason you will be cared for in a postnatal ward. Accommodation arrangements are varied and single rooms are allocated on a needs basis. Partners are not guaranteed accommodation and other family care arrangements will be needed. Please check with your chosen hospital for details.

If you need your first antenatal appointment in a public metropolitan maternity service in Adelaide you will need to call the Pregnancy SA Referral Line on 1300 368 820 to get a reference number and to be allocated to the hospital closest to your home.

During your pregnancy you will regularly visit either a midwife or doctor. This will depend on the well being of your baby or yourself.

In metropolitan Adelaide, women assessed as having a 'low risk' for problems during their pregnancy are encouraged to have all their care provided by midwives.

You may be able to choose to have your care by a small group of midwives where you mostly see the same midwife for your care during your pregnancy, birth and after the birth.

Alternatively you may have your care provided by midwives, but have one team of midwives providing your care before the birth, a different team providing care during labour and the birth, and different midwives providing care after the birth.

You may be able to choose to give birth in a birthing centre suite or in the delivery suite (labour ward).

At your first antenatal appointment the midwife will be able to tell you more about the choices that are available.

If at any time you need to be seen by a doctor, that doctor will be one employed within the hospital.

Most hospitals now have an early discharge option which you could choose if all is well. Midwives will visit you in your home on several days after your birth.

Hospital based antenatal management and birth by doctors and obstetricians is available for women who are at 'higher risk' for pregnancy complications, but women who are at 'low risk' can also choose this option.

Care before birth takes place in a hospital outpatient clinic.

You may not always see the same doctor or midwife during your pregnancy, and those caring for you during the antenatal period may not be involved with either your birth or after the birth.

It may be possible for you to visit your own doctor (general practitioner) or another GP for most of the check-ups during your pregnancy and after the birth of your baby. You will also need to see the midwives or doctors at the hospital where you will have your baby at certain stages during your pregnancy.

This is called shared care.

Not all general practitioners offer shared care.

Those who wish to do so undertake extra training to become accredited GP shared care providers.

During your labour and after the birth of your baby you will be cared for by hospital midwives and doctors.

Shared care can be a useful choice if you have difficulty attending hospital visits or if you live in a rural or remote area.

If you plan to have most of your care provided by a GP and the birth in a metropolitan public hospital you need to ring the Pregnancy SA Referral Line on 1300 368 820 to get a reference number and you will be allocated to the hospital nearest to your home.

If you have private health insurance, or if you are willing to pay the cost of the hospital care you can choose your own care giver - an obstetrician or independent midwife - and choose a private hospital or a public hospital for the birth.

Most hospitals will let you know which doctors or midwives have admitting rights to their hospital, which means they can deliver your baby there.

You will need to check with your health insurance fund to find out what type of care you are covered for during your pregnancy and birth, as this may vary.

If you choose care from a doctor, your doctor will be either an

Obstetrician (specialist). To see an obstetrician you will need to have a referral from a general practitioner.

A GP who has specialist training (GP Obstetrician). Not all general practitioners do antenatal care and deliveries. GP Obstetricians are not available in metropolitan Adelaide.

Many obstetricians employ a midwife in their rooms who will also be involved in your antenatal care.

Almost always there will be a gap between the amount your obstetrician will charge and the amount that you get back from Medicare. Your doctor is required to tell you about the gap charge when you have your first appointment. These gap fees may be quite large. Sometimes there will also be a gap between the cost of the hospital and the amount that your insurance company pays. It’s a good idea to have a talk with a consultant at your health insurance fund so that you know exactly what you are covered for and what costs you will have to pay yourself.

For the birth

For the birth of your baby you can choose a private hospital, or public hospital (as a private patient), depending upon where your doctor practices.

You will be cared for in labour by a midwife employed by the hospital but your doctor will be closely involved in your management and will be present at the birth.

Some private hospitals have birthing centre suites as well as delivery suites (labour wards).

Obstetricians and GP Obstetricians are able to perform instrumental deliveries (such as using forceps to assist the safe delivery of your baby) and Caesarean Sections should you or your baby need such assistance.

Postnatal care will also be provided by your doctor and the hospital midwives.

Most hospitals now have an early discharge option which you could choose if all is well. Midwives may be available to visit you in your home on several days after your birth.

Finding a doctor for your care

There are several ways that you can find an obstetrician or general practitioner to care for you during your pregnancy and birth.

Your general practitioner can refer you to an Obstetrician or to another general practitioner who offers antenatal care (shared care). Your doctor will be able to help you make your choice.

You can also contact your nearest public or private hospital and find out which Obstetricians or GP Obstetricians have admitting rights (that is, work at that hospital).

You may be able to find an obstetrician by looking in the Yellow Pages directory under Medical Practitioners: Specialty Guide: Obstetrics.

If your pregnancy is low risk you may not need to be referred to an obstetrician unless you wish to be. You may wish to go to a shared care GP or an independent midwife for some of your care.

If you live outside Adelaide you will need to find out at which hospital(s) near where you live, you can have your baby.

Ask your doctor, or ring or visit the hospital. You can also ask about the care choices available at that hospital.

You can choose to be treated either as a public or private patient. All women in South Australia can choose to be a public patient, but you may need to go further than your local hospital for your care.

Your own doctor may be able to see you for your antenatal care and possibly for the birth of your baby if your doctor has had specialist training.

At some places it may be possible for you to see a midwife or Aboriginal Health Worker at your pregnancy check-ups. Ask your doctor about this.

If you develop problems during your pregnancy, you may need to be referred to an obstetrician (specialist).

There may be an obstetrician nearby or you may need to travel to another town.

If you need to travel more than 100 km each way to see a specialist you can usually be reimbursed for part of your travel and accommodation expenses through PATS (Patient Assistance Transport Scheme). Talk to your doctor about PATS, or look at: http://www.rah.sa.gov.au/country/pats.php

If you or your baby develops problems when you are in hospital, you may need to be transferred to another hospital for higher level care. Some country women or their babies may need to be transferred to Adelaide.

If your baby needs to be transferred it may not be appropriate for you to be admitted to the hospital or beds may not be available so you may need to arrange other accommodation.

If you need to or choose to go to Adelaide or another place far away from home to have your baby you may still be able to have most of your pregnancy care with your own doctor or other local doctor who has had special training (Shared care). Your GP can share your care with an Obstetrician or hospital antenatal clinic.

The Metropolitan Aboriginal Family Birthing Program is a free service for Aboriginal women in metropolitan Adelaide who are pregnant. As part of the Program, you will be cared for by a group of midwives and one Aboriginal and Maternal Infant Care (AMIC) worker throughout your pregnancy, labour, birth and after your baby is born.

The South Australian Pregnancy Record (SAPR) is a hand-held antenatal medical record used by all women having a baby in South Australia. They are given the record (orange folder) by their midwife or obstetrician.